This study was undertaken to determine the relationship between traumatic rupture of the thoracic aorta (TRA) and the direction of impact at the time of motor vehicle crash.
Retrospective review of TRA patients from two different databases over a 4.5-year period (January 1, 1991 to June 30, 1995): (1) Ontario Coroner's Office records of motor vehicle deaths from Metropolitan Toronto, and (2) the trauma registries of Sunnybrook Health Science Centre and St. Michael's Hospital in Metropolitan Toronto.
Ninety-seven patients (81 from the coroner's database and 16 from the adult trauma unit registries) sustained traumatic rupture of the thoracic aorta. Forty-eight cases (49.5%) were a result of lateral impact crashes. Twenty-eight drivers (22 ipsilateral and six contralateral) and 20 passengers (16 ipsilateral and four contralateral) sustained TRA from lateral impact crashes. Ninety-one TRAs (94%) occurred at the peri-isthmic region.
Lateral impact crashes are a significant cause of TRA. Traumatic rupture of the aorta should be considered with a high index of suspicion after serious lateral impact crashes, just as physicians now consider patients at high risk of TRA after serious frontal impact crashes.